Clinical Efficacy of Tissue-Bone Homeostasis Manipulation on Soft Tissue Balance and Function in Knee Osteoarthritis

Knee osteoarthritis (KOA) is characterized by progressive joint degeneration and biomechanical imbalance of periarticular soft tissues, leading to pain and functional limitation. However, effective biomechanically targeted manual therapy protocols for regulating soft tissue tension remain insufficiently standardized. In this study, a randomized controlled design was used to investigate the effects of tissue-bone homeostasis manipulation (TBHM) on peri-knee soft tissue tension and functional outcomes in patients with KOA. Sixty patients were enrolled and randomly assigned to the TBHM group or the control group. Primary outcomes included rectus femoris, vastus medialis, vastus lateralis muscle tension, patellar ligament tension, and knee flexion range of motion (ROM). Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Timed Up and Go Test (TUGT). The results showed that baseline characteristics were comparable between groups (all P > 0.05), and no adverse events were observed during the intervention. Repeated measures analysis revealed significant time effects for all primary and secondary outcomes (P < 0.001). Significant group × time interaction effects were observed for rectus femoris, vastus lateralis muscle tension, patellar ligament tension, knee flexion ROM, KOOS subscales (symptoms, activities of daily living, sport/recreation, and quality of life), and TUGT (P < 0.05), indicating greater improvement in the TBHM group compared with the control group. However, no significant interaction effect was found for vastus medialis muscle tension or KOOS-pain (P > 0.05), suggesting similar trends between groups in these measures. In conclusion, TBHM demonstrates both safety and efficacy in reducing periarticular soft tissue tension and improving functional outcomes in KOA. This protocol provides a standardized and biomechanically oriented approach for manual therapy intervention and may offer a novel strategy for optimizing conservative treatment of KOA.